Practice Management
Shelter at home. Wash your hands. Use a tissue and properly dispose it. See your primary care if you are not feeling well. The advice goes on and on. But what if you are homeless? What if you do not have ready access to soap and water, or hand sanitizer, or tissues, or medical care? Universally, efforts to contain and mitigate pandemic diseases such as COVID-19 leave out a vulnerable population: people experiencing homelessness (PEH). …
Read MoreAfter the vivid video of the wrongful death of George Floyd went viral in late May, millions of people of all races in America and abroad took to the streets to demonstrate in the name of solidarity and justice. This was all motivated by one man’s story and, more broadly, was a potent remind of the power of story to capture our attention and provoke action. George Floyd was the most recent widely publicized victim …
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Joshua Russell, MD, MSc, FACEP MD; Ana Echenique, MD, DABR; Steven R. Daugherty, PhD; and Michael Weinstock, MD Abstract Background/Objective A prior study of patients presenting to urgent care (UC) centers with COVID-191 showed that only a small proportion of these ambulatory patients demonstrated significant pathology on chest x-ray (CXR). In this secondary analysis of 636 ambulatory patients with confirmed COVID-19 from greater New York City (NYC), our primary objective was to determine whether the …
Read MoreHydroxychloroquine in COVID-19 Herd Immunity for COVID-19 Treating Minor MSK Pain Primary Care Visit Trends in the U.S. POCUS in Children with Respiratory Illness POCUS in Vision Loss YIJUNG RUSSELL, MD Hydroxychloroquine Not Beneficial in Mild-to-Moderate COVID-19 Infections Contributing author: Lauren Bulgarelli, MD Key Point: Hydroxychloroquine was compared with the standard of care in a randomized trial and was not shown to be associated with a higher probability of negative conversion than the standard of …
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The patient is a 67-year-old man who presents with pain in his right shoulder and posterior right neck pain that he says radiates to his right arm. He reports that he first noted the pain “a few months ago” and is seeking care now because it has become more severe and “constant.” View the image taken and consider what the diagnosis and next steps would be. Resolution of the case is described on the next …
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The patient is a 47-year-old male who presents to urgent care with a painful, swollen right knee after crashing into a tree while trail biking through the woods. He is unable to bear weight on the leg due to the discomfort. View the x-ray and consider what the diagnosis and next steps would be. Resolution of the case is described on the next page.
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Urgent message: Point-of-care ultrasound (POCUS), just starting to become more prevalent in the urgent care setting, facilitates improved diagnostic and interventional clinical decision-making by aiding the clinician in discerning between cellulitis, abscess, or both. Chelsea M. Burgin, MD FAAFP and Dustin S. Morrow, MD FACEP INTRODUCTION Each year in the United States around 14 million patient encounters present with skin and soft tissue infections (SSTIs). A detailed history and focused exam differentiate between cellulitis and/or …
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The patient is a 20-year-old female who presents to urgent care with 2 days of nausea, vomiting, crampy abdominal pain, and inability to tolerate anything PO. Her personal medical history is remarkable for type I diabetes mellitus. View the ECG and consider what the diagnosis and next steps would be. Resolution of the case is described on the next page.
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Urgent message: The differential diagnosis is broad for patients presenting with chest trauma. Bedside ultrasound can expedite critical diagnoses and intervention(s) when pneumothorax is in the differential. CASE PRESENTATION History A 12-year-old male rolled an all-terrain vehicle (ATV) in the woods, sustaining head, torso, and extremity injuries. He was helmeted, but lost consciousness for an uncertain amount of time. His father found him and provided initial care at home. Because of persistent headache and vomiting, …
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Urgent message: With significant overlaps in clinical staff, patient population, and provider training between emergency medicine and urgent care, valuable insights relevant to urgent care can be gleaned from understanding the effect of incorporating provider-in-triage training into emergency medicine resident education. INTRODUCTION Crowding is a major barrier to timely and effective patient care in emergency departments. Crowding occurs when the demand for care exceeds the ability to supply it in an efficient fashion. This is …
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